RESUMO
ABSTRACT Inferior vena cava filter embolization is not uncommon and can reach 11.8%. However, device migration to the heart is not frequent and occurs in cases after inferior vena cava filter fracture. We present the case of a young woman who was submitted to a routine inferior vena cava filter placement three days before and presented with hemodynamic instability. Since the device was not retrievable, the surgical team opted for an open cardiac surgery under cardiopulmonary bypass to remove the inferior vena cava filter and avoid other further complications.
RESUMO
Inferior vena cava filter embolization is not uncommon and can reach 11.8%. However, device migration to the heart is not frequent and occurs in cases after inferior vena cava filter fracture. We present the case of a young woman who was submitted to a routine inferior vena cava filter placement three days before and presented with hemodynamic instability. Since the device was not retrievable, the surgical team opted for an open cardiac surgery under cardiopulmonary bypass to remove the inferior vena cava filter and avoid other further complications.
Assuntos
Filtros de Veia Cava , Feminino , Humanos , Filtros de Veia Cava/efeitos adversos , Ponte Cardiopulmonar , Veia Cava Inferior , Resultado do TratamentoRESUMO
Heyde syndrome manifests as aortic stenosis associated with gastrointestinal bleeding. We describe the case of a 64-year-old man who came to the emergency room due to acute heart failure and intermittent gastrointestinal bleeding. Treatment involves initial correction of anemia and heart failure followed by aortic valve replacement. The prosthesis used depends on the characteristics of each patient and valve replacement allows the resolution of bleeding in most cases. Gastrointestinal bleeding in patients with aortic stenosis is associated with severity of the valve obstruction. A mechanical prosthesis was used with no recurrent bleeding even with the need for lifelong anticoagulation therapy.
Assuntos
Estenose da Valva Aórtica/cirurgia , Hemorragia Gastrointestinal/cirurgia , Implante de Prótese de Valva Cardíaca/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome , Resultado do TratamentoRESUMO
Abstract Heyde syndrome manifests as aortic stenosis associated with gastrointestinal bleeding. We describe the case of a 64-year-old man who came to the emergency room due to acute heart failure and intermittent gastrointestinal bleeding. Treatment involves initial correction of anemia and heart failure followed by aortic valve replacement. The prosthesis used depends on the characteristics of each patient and valve replacement allows the resolution of bleeding in most cases. Gastrointestinal bleeding in patients with aortic stenosis is associated with severity of the valve obstruction. A mechanical prosthesis was used with no recurrent bleeding even with the need for lifelong anticoagulation therapy.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Estenose da Valva Aórtica/cirurgia , Implante de Prótese de Valva Cardíaca/métodos , Hemorragia Gastrointestinal/cirurgia , Síndrome , Resultado do TratamentoRESUMO
INTRODUCTION: The pacemaker implantation VDD is considered simpler, faster, less expensive and causes fewer complications compared to DDD. However, the VDD pacemaker has not been widely used in many centers, perhaps for fear of dysfunction of the sinus node and the reduction of atrial sensitivity by the pacemaker during follow-up after implantation. OBJECTIVE: To compare patients with DDD and VDD pacemakers regarding the evolution of chronic atrial fibrillation (AF) and length of stay outside this postoperative arrhythmia. METHODS: It was included 158 patients with dual chamber pacemakers, 48 DDD and 110 VDD. Follow-up period: between January 1, 1999 and December 31, 2015. The mean follow-up of patients with DDD was 5.35 years and the VDD, 4.74 years. The percentage of each group (DDD and VDD) which evolved to AF during follow-up was assessed. Also, it was made an actuarial study with the respective curves indicating the time free from AF for each group. Patients were classified according to the diagnosis that led to pacemaker implantation and the degree of heart failure. RESULTS: The percentage of patients who developed AF was higher in DDD group (10.42%) than in VDD group (6.36%), but without statistical significance. Patients with DDD and VDD remained free of AF for similar period. CONCLUSION: Considering the results, the VDD pacemaker continues to be a good option to the DDD for routine use in cases properly indicated.
Assuntos
Fibrilação Atrial/terapia , Estimulação Cardíaca Artificial/métodos , Análise Atuarial , Feminino , Seguimentos , Humanos , Masculino , Fatores de TempoRESUMO
Abstract Introduction: The pacemaker implantation VDD is considered simpler, faster, less expensive and causes fewer complications compared to DDD. However, the VDD pacemaker has not been widely used in many centers, perhaps for fear of dysfunction of the sinus node and the reduction of atrial sensitivity by the pacemaker during follow-up after implantation. Objective: To compare patients with DDD and VDD pacemakers regarding the evolution of chronic atrial fibrillation (AF) and length of stay outside this postoperative arrhythmia. Methods: It was included 158 patients with dual chamber pacemakers, 48 DDD and 110 VDD. Follow-up period: between January 1, 1999 and December 31, 2015. The mean follow-up of patients with DDD was 5.35 years and the VDD, 4.74 years. The percentage of each group (DDD and VDD) which evolved to AF during follow-up was assessed. Also, it was made an actuarial study with the respective curves indicating the time free from AF for each group. Patients were classified according to the diagnosis that led to pacemaker implantation and the degree of heart failure. Results: The percentage of patients who developed AF was higher in DDD group (10.42%) than in VDD group (6.36%), but without statistical significance. Patients with DDD and VDD remained free of AF for similar period. Conclusion: Considering the results, the VDD pacemaker continues to be a good option to the DDD for routine use in cases properly indicated.
Assuntos
Humanos , Masculino , Feminino , Fibrilação Atrial/terapia , Estimulação Cardíaca Artificial/métodos , Fatores de Tempo , Análise Atuarial , SeguimentosRESUMO
Objective The objective of this study was to prospectively evaluate the International Classification of Headache Disorders I (ICHD-I) diagnostic criteria for migraine in children and adolescents. Methods 150 pain diaries were analyzed during an initial consultation. The duration of migraine headache attacks were divided into 2 groups: Group I, for attacks lasting > 2 hours, and Group II, for attacks lasting < 2 hours.The two groups were statistically compared using Fisher’s exact test (p < 0.05). Results In this study, 51(34%) subjects were male and 99 (66%) were female, aged 7–15 years. Fisher’s exact test demonstrated that the ICHD-3 beta had a 58% sensitivity for Group I diagnoses and a 94% sensitivity for Group II diagnoses (p < 0.001). Conclusion The current ICHD-3 beta classification improves and advances migraine diagnosis in children and adolescents; however, more research is needed to identify additional characteristics of headache in this age group.
Objetivo O objetivo deste estudo foi avaliar prospectivamente os critérios diagnósticos da Classificação Internacional das Cefaleias 3 beta (CIC-3) de enxaqueca em crianças e adolescentes. Métodos 150 diários de dor foram analisados durante a consulta inicial. A duração dos episódios de enxaqueca foram divididos em dois grupos: Grupo I, para episódios com duração > 2 horas, e Grupo II, para os episódios < 2 horas. Os dois grupos foram comparados estatisticamente pelo teste exato de Fisher (p < 0,05). Resultados Neste estudo, 51 (34%) pacientes eram do sexo masculino e 99 (66%) eram do sexo feminino, com idade entre 7-15 anos. O teste exato de Fisher demonstrou que a CIC-3 beta teve sensibilidade de 58% para o diagnóstico do Grupo I e 94% para o diagnóstico do Grupo II (p < 0,001). Conclusão A atual classificação CIC-3 beta melhora e avança diagnóstico de enxaqueca em crianças e adolescentes; no entanto, mais pesquisas são necessárias para identificar as características adicionais de cefaléia nessa faixa etária.
Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Classificação Internacional de Doenças , Transtornos de Enxaqueca/diagnóstico , Transtornos de Enxaqueca/classificação , Transtornos de Enxaqueca/complicações , Medição da Dor , Estudos Prospectivos , Sensibilidade e EspecificidadeRESUMO
OBJECTIVE: The objective of this study was to prospectively evaluate the International Classification of Headache Disorders I (ICHD-I) diagnostic criteria for migraine in children and adolescents. METHODS: 150 pain diaries were analyzed during an initial consultation. The duration of migraine headache attacks were divided into 2 groups: Group I, for attacks lasting > 2 hours, and Group II, for attacks lasting < 2 hours.The two groups were statistically compared using Fisher's exact test (p < 0.05). RESULTS: In this study, 51(34%) subjects were male and 99 (66%) were female, aged 7-15 years. Fisher's exact test demonstrated that the ICHD-3 beta had a 58% sensitivity for Group I diagnoses and a 94% sensitivity for Group II diagnoses (p < 0.001). CONCLUSION: The current ICHD-3 beta classification improves and advances migraine diagnosis in children and adolescents; however, more research is needed to identify additional characteristics of headache in this age group.